The perfect OR

ORSmurf · Aug 20, 2005

Well, my ideal OR would have all cordless equipment! I know that is just a dream, but that's what I would love to see. I'd also love to see a universal pedal - instead of having four pedals to constantly shift around (bovie, PK, mosellator, harmonic scalpel). That would be a nice start :)

Christine, RN

What would your ideal be in an OR? If you could design the room and $$ was no object, what would you include?
What types of monitoring equipment do you use in the OR? (I mean, specific brands/models, not just EKG, BP etc.) Do you like them? What the good and bad aspects of each?
Do you have large screens to display vital info for others in the room to see? (I know we have large screens in the heart rooms positioned so the surgeons can see as well)
What about anesthesia machines? Other equipment/features?

suzanne4, RN · Aug 20, 2005

Each room equipped with built in towers that would contain most of the equipment that you have to wheel in, then around.

Bovie, lap equipment, etc. on a tower that can swing into place and out when not needed. Enough electrical outlets in the room and in proper places so that extension cords do not need to be run all over............

Screen so that the nurse can also see what is going on with the patient and not have to walk over to see anesthesia's monitor.

These are just a few things that come to my mind, have only been up for a few minutes.

MissJoRN, RN · Aug 20, 2005

Ugh...my OR is so outdated and tiny. I just dream of adequete cabinet space to hold the day's cases and linens (some have it some don't) a basic stock of suture (no rooms) stock dressings (it's hit or miss- one of many things and once a surgeon uses ACE, he rarly uses only one) gowns, extra basic drapes, basins (no rooms) etc!!

Counter space- some rooms have only about 2X2 foot square, in addition to prep tables to hold our paper work, spare supplies, sutures (which you see we had to run for), prep meds on, and on and on...

Electic bed in every room. A small warmer...I shouldn't have to leave the room, much less the halway to grab a blanket!

But then, think how much weight I'd gain back!!

Sorry to the OP, I won't comment on brand names since our models are no longer available anyway and I'm very out of touch with "state of the art" I'd like to hear what others have and want, less culture shock when I return to a bigger hospital!

mcmike55 · Aug 20, 2005

A really interesting question!!

Boy, some things come to mind in an instant. I agree, brand names don't interest me too much, but here's my thoughts.

Oh yes, things mounted on booms from the ceiling. That way we don't have to wheel stuff in and out.

Related...enough video equipment for each room.

How about a set of lights that could be aimed themselves or remote controlled. Skytron does that I think.

Also on that boom, how about a smoke evacuator!!! That's one of my big things!!!!

Electric beds of course!!

Cordless remotes and footpedals, would be great!

How about a mini nurses station. Included would be a work space, computer terminal, video monitoring/recording equipment. Phone, etc.

A hands off, intercom type system would be cool. That way you could contact the front desk, even if your hands were tied up with a bad patient, or doing a prep, etc.

How about a trackless, robot type system, that would ferry case carts in and out of the room!!?? Maybe blood samples and that sort of thing too.

Sometimes I wish we had the old style tube system again. Put something in a tube, dial the destination and....whoosh...it's gone. I mean computers are great too...but..........

I also agree, a small warmer for IV's, irrigation, and blankets in the room would be cool!

Ahhhhh such dreams!!! Mike

grimmy, RN · Aug 23, 2005

we already have booms in our new ors, but they are a mixed blessing. when we first got them, we discovered that their effective range was somewhat limited, and often stymied positioning. we went through a number of "room arrangements" for different procedures so that airflow wouldn't be blocked, or tables could be moved as needed, and the booms wouldn't hit a sterile field accidentally. i do love the flat-screen monitors that are hard-wired to the circulator's desk. lighting features at the circulator desk are sweet, too. we have the md's desk on the opposite side of the or from the circulator, and they have their own computer, which makes life a lot easier.

what i'd love to see are "lifts" for extremely heavy pts that could be effectively lowered from ceiling - something akin to those lifts that are used to put cargo boxes onto oceanic vessels. it probably wouldn't help with pts that have to be moved from prone to supine and vice-versa, but might help eliminate some disability issues.

Marie_LPN, RN, LPN, RN · Aug 24, 2005

People that leave their personal opinions at the front door (priceless).

I agree with ORSmurf. Cordless everything would be great. No more stuff to plug in, trip over, etc. And less pedals. So many foot pedals and cords, it looks like the surgeon's in a rock band.

Our booms seemed like a good idea, but half the time, they "drift" even if the brake button was pushed. What a pain.

A Pevco for each room.

A PACS monitor that doesn't take up so much space.

Tables that hold more than 700 pounds. Eventually, we'll need them.

Knee pads, for those times you're crawling on hands and knees on the floor.

yoga crna · Aug 24, 2005

Please let the anesthetists select their own anesthesia machines and monitors. There are different models on the market with different bells and whistles. My main criteria is a machine that can be powered with oxygen if the power goes off. The ability to troubleshoot is very important for both anesthesia machine and monitors. The anesthetists should be able to use them before a decision is made.

In my little office surgery center I use Datex/Ohmeda machines and monitors.

I agree with the cord issue. It would be nice to have everything wireless.

Yoga CRNA

ShirleyM · Aug 27, 2005

Funny that this thread is being posted...our two angio suites finished being renovated a couple of weeks ago and they're say they're going to start redoing our two lap rooms after JCHAO visits. From what I've been told, the suites are supposed to have surround sound plus a 'desk' for the circulator where the Bovie/light source/insufflation/Autosonix/Argon can be controlled at the desk without having to actually walk to the tower to adjust settings. We already have the video tower which holds the camera/insufflation/light source/VCR/printer but those things are a pain in the orifice to move, plus our slave monitor won't stop drifting. I won't get to see them renovate cuz' my last day there is next Fri, but I'll be sure to get updates on the construction...As for my perfect OR, I'd have the above plus no cords on the floor and cabinets stocked with linens/padding/supplies. I'd also have a bed that can handle patients over 700lbs, and anesthesia machines that have been selected, approved by the anesthesia group and isn't to troubleshoot.

porsch65 · Aug 28, 2005

What would your ideal be in an OR? If you could design the room and $$ was no object, what would you include?
What types of monitoring equipment do you use in the OR? (I mean, specific brands/models, not just EKG, BP etc.) Do you like them? What the good and bad aspects of each?
Do you have large screens to display vital info for others in the room to see? (I know we have large screens in the heart rooms positioned so the surgeons can see as well)
What about anesthesia machines? Other equipment/features?

Hi There,

Just going to offer my 2 cents here. We moved from 30 year old O.R's to state of the art O.R.'s about 16 monthes ago. Our rooms are bigger now, better for all that equipment. The company that built our new building has built several O.R.'s around the country. Some things they did well and other things well... you can tell they didn't talk to O.R. nurses. We have booms in everyroom and most of our equipment fits on the booms. Each room has access to a PAC system, great for surgeons, but the hookup is kind of in the way of where we put our sterile field when we are setting up our cases. We have the Tulip system in two of six rooms so that your circulator can turn things on via a computer screen. Big waste of money as far as I am concerned because when you think about it, you have to go to the boom to plug everything in right, your bovie, smoke evacuator, light cords, insufflator, gas for drills etc. etc... so you might as well turn it on while you are standing beside the boom. The most important thing that I think is lacking in our O.R.'s is one completely clear wall where you can set up your sterile field. Right now there seems to be something against every darn wall. Drive's me nuts!!!! One differance I notice now from the new place and the old place, is that I can't hear a darn thing!!! We now have laminar air flow in every room and the walls are smooth. In the old place we did not have laminar airflow and the walls were tiled with grout. The old place seemed to act like a acoustic baffle for lack of a better word nutty or what, eh! As far as cords go, I'd love to see cords that retract back into your equipment after you used them, like the old fashioned electrolux vaccum cleaners. Boy am I dating myself or what. I'd like to see that with your monitor cords as well. We use Datex gas machine which were selected by our gasmen. The nice thing about the new machines, is I take the first blood pressure and my gasmen shows up two minutes later b/c he has a monitor in his office and can monitor anyone hooked up to a Datex monitor in the hospital, be they in Emerg, ICU or our theatres or Recovery Room. Sure saves on phonecalls and paging. We have flat screens on booms and slave monitor for the assistant. Very nice, nobody gets a crick in the neck anymore. And for me the number one improvement is the fact that we have real windows!!!! The windows also have no touch blinds between two panes of glass, for when you are doing laporscopic surgery. We are now on the second floor where as before we were on the first floor and had no windows. In the winter it seems like you go to work in the dark and then go home in the dark 8 hours later. I think I started to suffer from a little bit of SAD my first few years in the O.R. come winter. So having real light is a personal bonus for me.

Every room is outfitted with boom for gas, boom with camera, insufflator, erbe, smoke evacuator, suction and is lazer ready. Each room has computer and we are slowly getting hooked up with med series 4. We have a fullsized two compartment warmer, for fluids and blankets in each room. There are also wall mounted cabinets for supplies such as sutures dressings, foleys etc. These wall mounted items can all be removed within a minute if we are doing a MRSA case. Saves on cleaning for our cleaning staff etc. and we then keep a minimum of supplies in the room then. All beds are electric and can be modified. In one of our rooms the light fixture has a video camera built into the handle. This was supposedly thrown in for free when we went with a new vendor for lights. The camera can be moved into any room with just a call to bio-med. We are able to record any surgery, as well as watch the surgery on the monitors. Only drawback is sometimes all the ciruclator or scrub for that matter can see is either the surgeons head or his hands.

All of our doors into the sterile core have a sidelight window in them, I'd like to see a blind in the door, when you want to close those windows when you are doing laser. We have automatic main doors, some are two doors that swing wide open, and then we have some that are triple doors that slide onto one another. Don't really care for those, especially when people are entering back and forth and there you are sitting with your sterile field.

We found that when we moved into our new place yes it was big and beautiful, but after a couple of weeks, it was a lot of little things, like what were they thinking? I would have liked to see the company come back to us 6 to 12 months later to do a survey and say okay, what did we do well and what can we do better. They come in with their ideas, and don't really take into consideration the end use or look at things the way the user will use the room. Each gasman has his own anaesthetic cart, and his stocked to his specifications and then the other standard stuff. We then wheel it from room to room from one day to the next.

The floor above us is basically all crawl space for wiring, gas lines, etc. All the infrastructure is there for Hermes someday. Personally I think that could be a big waste of money, more to satisfy a surgeons ego, than practical. But until you use something, ...I'm sure I could be way off base on that one. Anyways I am definitely starting to ramble here... But the best improvements, would have to be size of rooms, one wall clear of equipment, windows, booms and departmental layout. Our surgical suite is laid out like a racetrack with the sterile core in the middle.

I think the most important thing in building a new O.R. is to talk to the end user and make sure that it fits everybody's needs and makes sense.

grimmy, RN · Aug 28, 2005

another new development which includes more than the ors but really has my seal of approval is text messaging the physicians and other staff. it really cuts down on the time i have to run across the room to answer the phone. i can just type the message on the same computer that i do my charting, and it automatically sends the text page to the right person. it saves me an incalculable amount of busy-work i'd rather be spending elsewhere. mds/staff really like it because they don't necessarily have to call back, find a phone, etc.

love it! :yelclap:

**RosesrReder, BSN, MSN, RN** · Aug 28, 2005

All these are awsome ideas. Only if most did happen....right :)